Valero’s host index is useful in predicting radiation-induced trismus and osteoradionecrosis of the jaw risks in locally advanced nasopharyngeal carcinoma patients

BMC Cancer · 5 authors, 5 centres

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TL;DR

This retrospective cohort study of 295 locally advanced nasopharyngeal carcinoma patients found that a pre-treatment H-Index greater than 5.5, determined by ROC curve analysis, independently predicted significantly higher rates of radiation-induced trismus (31.8% vs. 5.9%) and osteoradionecrosis of the jaw (17.3% vs. 2.2%) following concurrent chemoradiotherapy.

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Using ROC curve analysis, an optimal H-Index cutoff of 5.5 was identified (AUC 82.3% for RIT, 81.6% for ORNJ). Patients with H-Index > 5.5 had significantly higher rates of RIT (31.8% vs. 5.9%; P < 0.001) and ORNJ (17.3% vs. 2.2%; P < 0.001) compared with those at or below 5.5. Limitations include the retrospective single-institution design, single time-point H-Index assessment, and absence of cytokine/chemokine correlations to elucidate mechanistic links.

STUDY TYPE

cohort

SPECIALTY

oncology

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ORIGINAL PAPER

PMC10337124

Valero’s host index is useful in predicting radiation-induced trismus and osteoradionecrosis of the jaw risks in locally advanced nasopharyngeal carcinoma patients

BMC Cancer

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ABSTRACT

Background In the absence of previous research, we sought to assess the H-Index’s predictive significance for radiation-induced trismus (RIT) and osteoradionecrosis of the jaw (ORNJ) in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) receiving concurrent chemoradiotherapy (C-CRT). Patients and methods The research comprised 295 LA-NPC patients who had C-CRT and pre- and post-C-CRT oral exams between June 2010 and December 2021. The H-Index was calculated using neutrophils, monocytes, lymphocytes, hemoglobin, and albumin measurements obtained on the first day of C-CRT. Patients were divided into three and two H-index groups, respectively, based on previously established cutoff values (1.5 and 3.5) and the cutoff value determined by our receiver operating characteristic (ROC) curve analysis. The primary objective was the presence of any significant connections between pretreatment H-Index groups and post-C-CRT RIT and ORNJ rates. Results RIT and ORNJ was diagnosed in 46 (15.6%) and 13 (7.8%) patients, respectively. The original H-Index grouping could only categorize RIT and ORNJ risks at a cutoff value of 3.5, with no significant differences in RIT and ORNJ rates between groups with H-Index 1.5 and 1.5 to 3.5 (P < 0.05 for each). The ideal H-Index cutoff for both RIT and ORNJ rates was found to be 5.5 in ROC curve analysis, which divided the entire research population into two groups: H-Index ≤ 5.5 (N = 195) and H-Index > 5.5 (N = 110). Intergroup comparisons revealed that patients in the H-Index > 5.5 group had significantly higher rates of either RIT (31.8% vs. 5.9%; P < 0.001) or ORNJ (17.3% vs. 2.2%; P < 0.001) than their H-Index ≤ 5.5 counterparts. The results of the multivariate analysis showed that H-Index > 5.5 was independently linked to significantly higher RIT (P < 0.001) and ORNJ (P < 0.001) rates. Conclusion Pre-C-CRT H-Index > 5.5 is associated with significantly increased RIT and ORNJ rates in LA-NPC patients receiving definitive C-CRT.

CITATION EXPORT

Erkan Topkan, Efsun Somay, Busra Yilmaz et al.. Valero’s host index is useful in predicting radiation-induced trismus and osteoradionecrosis of the jaw risks in locally advanced nasopharyngeal carcinoma patients. BMC Cancer. (2023). https://doi.org/10.1186/s12885-023-11155-z

AUTHORS

5 · 5 CENTRES

Erkan Topkan, Efsun Somay, Busra Yilmaz, Berrin Pehlivan, Ugur Selek

1grid.411548.d0000 0001 1457 1144Department of Radiation Oncology, Medical Faculty, Baskent University, Adana, Turkey
2grid.411548.d0000 0001 1457 1144Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Ankara, Turkey
3grid.10359.3e0000 0001 2331 4764Department of Oral and Maxillofacial Radiology, School of Dental Medicine, Bahcesehir University, Istanbul, Turkey
4grid.10359.3e0000 0001 2331 4764Department of Radiation Oncology, Bahcesehir University, Istanbul, Turkey
5grid.15876.3d0000000106887552Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey